Post-licensing visit·August 17, 2022

Licensing Program Analyst (LPA) Arielle Pascua conducted an unannounced visit on this day for the purpose of conducting a Post Licensing Evaluation. LPA Pascua arrived and was greeted by Caregiver, Cynthia Miller. LPA Pascua asked Caregiver, Miller to contact the Facility Designated Administrator (FDA) to let them know that CCL was present at this time. FDA Cosmina Stancu arrived shortly after LPA Pascua's arrival. This facility is licensed to serve and accept up to 6 residents who are deemed to be non-abulatory only. . Administrator holds a current certificate and expires on, 01/25/2023. Current Census was 2. Tour of the facility was conducted. Fire extinguisher located in the kitchen was purchased on 02/07/2022. Dining areas, living areas, and all other areas intended for resident use were toured. It was observed that furniture and furnishings were sufficient and able to meet the needs of the residents at this time. Kitchen area was toured. Food storage units were reviewed for adequate 2-day perishable and 7-day non perishable quantities at this time. Knives were locked and made inaccessible to the residents at this time. LPA Pascua observed a locked centralized stored medication cabinet located in the kitchen. Along with the administrator, the LPA observed, reviewed, and compared resident medication and medication dispensing logs. First Aid Kit was present and contained all of the required components. A linen closet was located in the hallway and presented a sufficient amount of linens to adequately supply and meet the needs of the residents at this time. Laundry area was toured. Laundry detergent, bleach, and all other cleaning supplies were observed to be locked and made inaccessible to the residents at this time. A tour of the bedrooms was conducted. Resident furniture was observed to be sufficient to meet resident needs at this time. A tour of the bathrooms was conducted. Hot water temperature was measured and observed to be within the required range of 105-120 degrees. The exterior of the physical plant was in good repair with no hazards present. Perimeter fence was observed to be stable and gates were in good repair. A copy of this report was provided to the Facility Designated Administrator. Exit Interview.